Causes of Rib Cage Pain

There are many possible causes of rib cage pain or pain that seems to come from the area around your ribs. These can range from conditions that are primarily a nuisance to those that are life-threatening.

We will look at common and uncommon causes musculoskeletal causes of this pain, as well as causes that may be felt in the rib cage but instead originates in organs within or outside of the rib cage. When the cause of rib pain is uncertain, a careful history and physical exam can help guide you and your doctor to choose any labs or imaging studies that are needed.

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Rib Cage Anatomy and Structure

When looking at potential causes and how rib cage pain is evaluated, it’s helpful to think about the structures in and around the rib cage.

Bony Structure

There are 12 ribs on each side of the chest. The upper seven ribs are attached directly to the breastbone (sternum) via cartilage. These are known as the “true ribs.” The remaining five ribs are referred to as the “false ribs.”

Of these, ribs eight through 10 are also attached to the sternum, but indirectly (they attach to the cartilage of the rib above which ultimately attaches to the sternum). Ribs 11 and 12 are not attached to the sternum either directly or indirectly and are called the floating ribs.

There can be variations to this pattern, with some people having an extra set of rubs and some have fewer ribs (primarily the floating ribs).

Surrounding Structures

In addition to the bones that make up the ribs, sternum, and spine, as well as the attaching cartilage, there are many other structures associated with the rib cage that could potentially cause pain. This includes the intercostal muscles (the muscles between the ribs) and the diaphragm (the large muscle at the base of the chest cavity), ligaments, nerves, blood vessels, and lymph nodes.

Organs Within the Rib Cage

The rib cage functions to protect several organs while allowing movement so that the lungs can expand with each breath.

Organs protected by the rib cage include the:

• Heart
• Great vessels (the thoracic aorta and part of the superior and inferior vena cava)
• Lungs and pleura (lining of the lungs)
• Upper digestive tract (esophagus and stomach)
• Liver (on the right side at the bottom of the rib cage)
• Spleen (on the left side at the bottom of the rib cage)

The area between the lungs, called the mediastinum, also contains many blood vessels, nerves, lymph nodes, and other structures.

Organs Outside of the Rib Cage

Organs not within the rib cage but that can sometimes cause pain that feels like it comes from the rib cage include the gallbladder, pancreas, and kidneys. The skin overlying the rib cage may also be affected by conditions (such as shingles) which cause rib cage pain.

Anatomical Variations

There are a number of variations that may be found in the rib cage that can, in turn, lead to or affect symptoms in this region.

• Extra ribs: An extra rib lies above the first rib in 0.5% to 1% of the population and is called a cervical rib or neck rib.
• Missing ribs, most often one of the floating ribs
• Bifurcated (bifid) ribs, a condition present from birth in which the rib splits into two parts by the sternum
• Pigeon chest (pectus carinatum), a deformity in which the ribs and sternum stick out from the body
• Sunken chest (pectus excavatum), in which abnormal growth of the ribs results in the chest having a sunken appearance

Causes

There are many potential causes of pain that feels like it arises from the rib cage, including injuries, inflammation, infection, cancer, and referred pain from organs such as the heart, lungs, spleen, and liver.

In an outpatient clinic setting (such as a family practice clinic), musculoskeletal conditions are the most common cause of rib cage pain. In the emergency room, however, serious conditions that mimic rib cage pain (such as a pulmonary embolism) are more common. 

We will look at some of the common and uncommon musculoskeletal causes or rib cage pain, as well as causes that may arise from organs within or outside of the rib cage.

Common Musculoskeletal Causes

Some of the more common musculoskeletal causes of rib cage pain include:

Injuries

Muscle strains may occur with an injury or even coughing or bending. Rib fractures are relatively common and can sometimes cause intense pain. Ribs can also be bruised (bone bruise) without a fracture.

The sternum is infrequently fractured, but chest trauma can result in a number of abnormalities ranging from single fractures to flail chest. With osteoporosis, rib fractures can sometimes occur with very little trauma.

Inflammation

Costochondritis is an inflammatory condition that involves the cartilage that connects the ribs to the sternum. The condition is common, and can sometimes mimic a heart attack with the type of pain that occurs.

Fibromyalgia

Fibromyalgia is a relatively common cause of rib cage pain and can be challenging to both diagnose and treat (it’s primarily a diagnosis of exclusion). Along with pain and morning stiffness, people with the disorder often experience mental fog, fatigue, and other annoying symptoms.

Rheumatoid Conditions

Common rheumatoid conditions that can cause rib cage pain include rheumatoid arthritis and psoriatic arthritis.

Intercostal Neuralgia

Intercostal neuralgia is a condition in which nerve pain (neuropathic pain) arises from an injury, shingles, nerve impingement, and more. It can be challenging both to diagnose and treat.

Slipping Rib Syndrome

Slipping rib syndrome (also called lower rib pain syndrome, rib tip syndrome, or 12th rib syndrome) is thought to be under-diagnosed and can cause significant pain in the lower ribs (the floating ribs). In the condition, it’s thought that overly mobile floating ribs slip under the ribs above and pinch the intercostal nerves, nerves that supply the muscles that run between the ribs.

Other

Other relatively common causes can include pain related to conditions involving the thoracic spine (which not uncommonly causes chest pain in the front of the rib cage), Sternalis syndrome, and painful xiphoid syndrome (the xiphoid is the pointy bony growth at the bottom of the sternum).

Less Common Musculoskeletal Causes

Less common, but significant musculoskeletal causes of rib cage pain can include:

Rib Stress Fractures

Rib stress fractures are an overuse injury commonly seen with activities such as rowing or backpacking. They can be challenging to diagnose, so it is important to let your doctor know what type of exercises and sports you participate in.

Tietze Syndrome

Tietze syndrome is similar to costochondritis but less common. Unlike costochondritis, there is swelling that accompanies the inflammation of the cartilage connecting the ribs to the sternum.

Malignancies

A number of cancers can lead to rib cage pain. Both lung cancer and breast cancer commonly spread (metastasize) to bones, including those of the rib cage. This can occur with a number of different cancers as well.

Pain may be due to the presence of the tumor in bone (bone metastases) or due to fractures that result in weakened bones (pathologic fractures). In some cases, rib cage pain may be the first symptom of the cancer.

These tumors may also grow directly in to the rib cage and cause pain. Multiple myeloma is a blood-related cancer that may occur in the bone marrow of the rib cage and other bones and can also cause rib cage pain.

Other

A sickle cell crisis (bone infarct or essentially a death of bone) is an uncommon cause of rib cage pain. Rheumatoid causes such as lupus are less commonly associated with rib cage pain.

Some other potential but infrequent causes include infections in joints in the rib cage (septic arthritis), polychondritis, and sternoclavicular hyperostosis.

Non-Musculoskeletal Causes

It can sometimes be very difficult to know whether pain that is felt in the rib cage is related to rib cage itself, or underlying structures. Some potential causes of rib cage pain include the following.

Shingles

Shingles is a condition in which the chickenpox virus (which remains in the body after the initial infection) reactivates. Symptoms include fever, chills, and rash distributed on one side of the body, but pain (which can be severe) often occurs before these other symptoms and can be challenging to diagnosis.

Heart Disease

Heart disease not uncommonly causes pain that is felt as rib cage pain, and women especially, tend to have atypical symptoms such as these. The possibility of a heart attack should always be considered in a person who has any form of chest-related pain. Pericarditis, an inflammation of the membrane that lines the heart is also a potential cause.

Aorta

Enlargement of the large artery (aorta) in the chest may cause rib cage pain. Risk factors include the condition Marfan’s syndrome as well as cardiovascular disease.

Lung Conditions

Lung conditions such as pneumonia or lung cancer may cause rib cage pain. Lung cancer, in particular, may irritate nerves that lead to pain that feels like it originates in the rib cage. Pulmonary emboli, or blood clots in the legs (deep venous thromboses) that break off and travel to the lungs are a serious cause of rib cage pain.

Pleural Conditions

Inflammation of the pleura (pleurisy) or the build-up of fluid between the two layers of pleura can cause rib cage pain. This may cause pain with a deep breath and in some positions more than others.

Enlargement of the Spleen

Spleen enlargement, such as with some blood-related conditions or cancers, may cause rib cage pain. The spleen may also become enlarged (and sometimes rupture with mild trauma) with the infectious mononucleosis.

Liver Conditions

Inflammation or scarring of the liver, such as with hepatitis or cirrhosis may cause rib cage pain.

Digestive System Conditions

Gastroesophageal reflux disease (GERD) often causes heartburn, but can also cause other types of pain. Peptic ulcer disease or gastritis are other potential causes.

Referred Pain From Outside of the Rib Cage

Organs outside of the rib cage may also cause pain that feels like it arises in the rib cage. Some of the organs and medical conditions to consider include:

• Gallbladder: Gallstones or cholecystitis (infection of the gallbladder)
• Pancreas: Pancreatitis or pancreatic tumors
• Kidneys and ureters: Kidney stones may sometimes cause referred pain that’s felt in the rib cage (and is often severe).

Rib Cage Pain in Pregnancy

Rib cage pain, especially upper rib cage pain, is also relatively common in pregnancy. Most of the time it’s thought that the pain is due to the positioning of the baby or related to the round ligament.

Much less commonly, and after the 20th week of gestation, pain on the right side felt under the lower ribs is sometimes a sign of preeclampsia or HELLP syndrome, a medical emergency.

When to See a Doctor

If you are experiencing rib cage pain that does not have an obvious explanation, it’s important to make an appointment to see your doctor.

Symptoms that should alert you to call 911 and not wait include:

• Chest pressure or tightening
• Pain in the rib cage that radiates into your arm, back, or jaw
• Heart palpitations
• Shortness of breath, especially of sudden onset
• Pain that is severe
• Sudden onset of sweating
• Lightheadedness
• New onset confusion or change in consciousness
• Coughing up blood, even if only a very small amount
• Difficulty swallowing
• Numbness or tingling in your arms or legs

Diagnosis

In order to determine the cause or causes of rib cage pain, your doctor will take a careful history and may do a number of different tests based on your answers.

History

A careful history is essential in making a diagnosis when the cause of rib cage pain in unknown. The questions noted above may help narrow down potential causes and further guide your work-up. These will include questions to not only understand the characteristics of your pain, but a review of past medical conditions, risk factors, and family history.

To narrow down potential causes, your doctor may ask a number of questions. Some of these include:

• What is the quality of your pain? Is the pain sharp or dull?
• How long have you had the pain? Did it start gradually or abruptly?
• Have you ever experienced pain like this in the past?
• Where is the location of your pain? Is it localized or diffuse? Does it affect both sides of your chest or is it isolated to the left side or right side?
• Is there anything that makes your pain better or worse? For example, pain with a deep breath (pleuritic chest pain) may suggest pleurisy or other lung conditions. Movement may worsen musculoskeletal pain.
• Is the pain present at rest or only with movement?
• Is the pain worse during the day or at night? Pain that is worse at night may suggest serious causes such as an infection, fracture, or cancer.
• Is the pain worse in one particular position (PE)?
• Can your pain be reproduced by pressing on any area of your chest?
• If you also have neck or shoulder pain, does it radiation to your arms? Do you have any weakness, tingling, or numbness of your fingers?
• What medical conditions do you have and have you had? For example, a history of early stage breast cancer in the past might raise concern over a bony recurrence in the rib cage.
• What illnesses have your family members experienced (family history)?
• Do you or have you ever smoked?
• What other symptoms have you experienced (associated symptoms)? Symptoms such as palpitations, shortness of breath, a cough, a rash, jaundice (a yellowish discoloration of the skin), nausea, vomiting, itchy skin, etc. should be shared with your doctor.

Physical Exam

On physical examination, your doctor will likely begin with an examination of your chest (unless you have symptoms suggesting an emergency condition is present). Palpation (touching) your chest will be done to look for any localized areas of tenderness, such as over a fracture or inflammation.

With costochondritis, pain is most commonly noted with palpation to the left of the sternum in a very localized region. Swelling may be related can occur if Tietze syndrome is present or with an injury such as a fracture.

With fractures, tenderness is usually very localized. With sternalis syndrome, pain is often felt over the front of the rib cage, and palpation can cause the pain to radiate to both sides of the chest. With intercostal neuralgia, pain may be felt over the whole chest or along one rib, but can not usually be reproduced with palpation.

Range of motion tests, such as having you lean forward (flexion), stand up straight (extension), and turn to the right and left are done to see if any of these movements can reproduce the pain.

An examination of your skin will be done to look for any evidence of shingles rash, and an examination of your extremities might show signs of a rheumatoid condition such as any swelling or deformity of joints. In addition to examining your chest, your doctor will likely listen to your heart and lungs and palpate your abdomen for any tenderness.

A pleural friction rub is a breath sound that may be heard with inflammation of the lining of the lungs (the pleura). Other breath sounds might suggest an underlying pneumonia or other lung conditions.

In women, a breast exam may be done to look for any masses (that could spread to the ribs).

Labs and Tests

A number of laboratory tests may be considered depending on your history and physical exam. This may include markers for rheumatoid conditions and more. Blood chemistry including a liver panel, as well as a complete blood count may give important clues.

Imaging

Imaging tests are often needed if trauma has occurred, or if there are any signs to suggest an underlying cancer or lung disease. A regular X-ray may be helpful if something is seen, but cannot rule out either a fracture or lung cancer.

Rib detail exercises are better for visualizing the ribs, but can still easily miss rib fractures. In order to diagnose many rib fractures or stress fractures, an MRI may be needed. A bone scan is another good option both for detecting fractures and looking for potential bone metastases.

A chest computed tomography scan (CT scan) is often done if there is concern over lung cancer or pleural effusion. With cancer, a positron emission tomography (PET) scan can be good both for looking at bony abnormalities and other soft tissue spread, such as tumors in the mediastinum.

Since abdominal conditions (such as gallbladder or pancreatic conditions) may cause rib cage pain, an ultrasound or CT scan of the abdomen may be done.

Procedures

Procedures may be needed to diagnosis some conditions that can cause referred pain to the rib cage.

An electrocardiogram (ECG) may be done to look for any evidence of heart damage (such as a heart attack) and to detect abnormal heart rhythms. An echocardiogram (ultrasound of the heart) can give further information about the heart and also detect a pericardial effusion (fluid between the membranes lining the heart) if present.

If a person has had a choking episode or has risk factors for lung cancer, a bronchoscopy may be done. In this procedure, a tube is inserted through the mouth (after sedation) and threaded down into the large airways. A camera at the end of the scope allows a physician to directly visualize the area inside the bronchi.

Endoscopy may be done to visualize the esophagus or stomach for conditions involving these organs.

Treatment

The treatment of rib cage pain will depend on the underlying cause. Sometimes this simply requires reassurance and advice to avoid activities and movements that aggravate the pain.

Rib fractures are difficult to treat, and many physicians are leaning against only conservative treatments such as wrapping the rib cage due to the potential for complications.

For musculoskeletal causes of rib cage pain, a number of options may be considered ranging from pain control, to stretching, to physical therapy, to local injections of numbing medication.

A Word From Verywell

Rib cage pain can signal a number of different musculoskeletal conditions as well as non-musculoskeletal conditions within or outside of the chest. Some of these conditions can be challenging to diagnose. Taking a careful history is often the best single “test” in finding an answer so the underlying cause can be treated.

It can be frustrating to be asked a thousand questions (that are sometimes repeated more than once), but in the case of rib cage pain, is worth the time it takes to make sure you doctor has all of the clues possible to diagnose, and subsequently treat, your pain.

MS Hug (Girdling Pain Around Torso): Symptoms, Duration, Treatment

If you have multiple sclerosis, an autoimmune disease that affects the brain and spinal cord, you might have felt a band of pain around your torso. It’s often called the “MS hug.”

What It Feels Like

Like most MS symptoms, it’s different for each person. You might feel it right under your rib cage, in your chest, or anywhere between your neck and waistline. It can be:

• Burning
• Dull and achy pain
• Hard to breathe
• Pain on one side of your body
• Pressure
• Sharp pain
• Tickling
• Tightness
• Tingling or pins and needles
• Vibration

It can last a few seconds to a few hours, and in rare cases, a few days. People often say it’s like wearing a girdle around the middle of your body. For that reason, you may also hear it called by a number of names, like:

• Banding
• Girdle-band
• Girdling
• MS girdle

You might feel it in your head, hands, or feet instead. People with this type of sensation feel like they’re wearing tight gloves or boots. Read more about muscle spasms and tightness with MS.

What Causes It?

MS affects the way nerves send messages. The tightness, pain, or whatever you’re feeling results from spasms in small muscles between your ribs. The doctor will call these intercostal muscles. They hold your rib cage together and help it expand when you move, bend, or breathe. If these muscles have spasms, you feel painful, tightening pressure.

The hug is a type of nerve pain. You might hear a doctor call it dysesthesia, which means a sensation that isn’t normal.

If other symptoms come on quickly at the same time, the hug can also be a sign that your MS is relapsing. Call your doctor if this happens. Get more information on what dyesthesia pain feels like with MS.

What Should You Do?

If you think you’re having an MS hug, talk to your neurologist or main doctor right away. The symptoms can seem like those of a heart attack, so it’s important to make sure that’s not the case and to rule out any other causes of the pressure.

Your doctor will most likely give you an MRI to look for other things, like gallbladder problems or lung disease. MS hug can also happen to people with other rib and spinal cord conditions.

Can You Prevent It?

Yes. The hug responds to the same triggers as other MS symptoms. Keep notes and learn what sets yours off. It might show up, or get worse if you’re:

Medications for MS Hug

You may not need treatment. But if you do, what your doctor gives you will depend on the cause.

If they think your symptoms signal a relapse, you might get steroids to help prevent it:

Your doctor may suggest over-the-counter treatments like:

Or they could prescribe other medications, including:

Your health care team will work with you to choose the best mix of treatments for you.

How to Manage the MS Hug

You can try these things at home:

• Apply a warm compress. (Be careful: Heat might make your pain worse.)
• Drink plenty of water.
• Eat healthy food.
• Get a massage.
• Stay rested. Get at least 8 hours of sleep each night.
• Use deep breathing techniques, yoga, and meditation.
• Some people get relief from wearing tight clothing but may prefer loose clothing.

View a slideshow to learn more about other unusual symptoms of MS.

Upper Back Pain from Intercostal Muscle Strain

An intercostal muscle strain refers to a muscle injury between two or more ribs. The intercostal muscles, commonly referred to simply as the intercostals, connect the ribs and help make up the chest wall. When these muscles overstretch or tear, they can cause significant pain in the mid- and upper back.

See All About Upper Back Pain

Intercostal muscle strain is a common injury in athletics and hard labor. It is not typically caused by everyday activity. While an intercostal muscle injury can cause intense pain, most cases are fully healed within 6 to 8 weeks.

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What Are the Intercostal Muscles?

There are 11 sets of intercostal muscles on each side of the rib cage, and each set is located between adjacent ribs in the upper- and mid-back.

See Thoracic Spine Anatomy and Upper Back Pain

Causes of Upper Back Pain

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Each set of intercostal muscles consists of the following:

• External intercostal muscles are the outermost intercostals, responsible for expanding the chest during breathing to help inhale air and allow for full, deep breaths.¹ The external intercostals originate at the lower edge of one rib and run diagonally forward to attach to the upper edge of the rib below, and are found in the back, sides, and most of the front of the rib cage.²
• Internal intercostal muscles sit directly underneath the external intercostals and help collapse the chest during breathing to exhale air. ¹ The intercostal muscle fibers run perpendicular to the external intercostals, moving diagonally from front to back along the ribs, and are found in the entire rib cage.²
• Innermost intercostal muscles sit directly underneath and run parallel to the internal intercostal muscles, and run from the back of the rib cage to each side. The intercostal veins, arteries, and nerves are typically found between the internal and innermost intercostal muscles.

In This Article:

In addition to aiding in breathing, the intercostal muscles also help stabilize the rib cage as the upper body twists or bends forward, backward, or to the side. While the intercostal muscles do not connect directly to the spine, their stabilizing role in the rib cage assists in maintaining posture and keeping the back strong and healthy.

See Good Posture Helps Reduce Back Pain

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When to See a Doctor

Some cases of intercostal muscle strain may be so mild that pain or stiffness alleviates within a few days, and thus does not necessitate medical attention. It is advisable to see a doctor if upper back pain persists for several days or begins to interfere with daily activity, such as going to work or sleeping.

Additionally, medical attention is advisable if upper back pain is so severe that it causes difficulty breathing or makes everyday movements feel impossible, such as lying down or moving from standing to sitting. Severe pain that occurs following a traumatic injury, such as a fall or car accident, should be promptly addressed by a doctor.

References

• 1.Bakkum BW, Cramer GC. Muscles that influence the spine. In: Cramer GC, Darby SA, Clinical Anatomy of the Spine, Spinal Cord, and Ans, 3rd Edition. St. Louis, MO: Elsevier; 2014: 122.
• 2.Rakovich G, Fréchette É, Deslauriers J. Thoracic surgical anatomy and procedures. In: Lewis MI, McKenna RJ, Medical Management of the Thoracic Surgery Patient. Philadelphia, PA: Saunders, Elsevier Inc; 2010. http://www.sciencedirect.com/topics/neuroscience/innermost-intercostal-muscle. Accessed September 5, 2017.

The painful rib syndrome

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The painful rib syndrome is thought to arise from the inadequacy or rupture of the interchondral fibrous attachments of the anterior ribs. This disruption allows for the subluxation of costal cartilage tips, impinging on the intercostal nerves. This may cause a variety of somatic and visceral complaints. [1,2,3,4,5] Although the diagnosis may be made based on history and physical examination, lack of recognition of this disorder frequently leads to extensive diagnostic evaluations before definitive therapy. We depict the case study of three patients with painful rib syndrome who presented within a year’s time. The diagnosis had not been made prior to our consultation.

Case 1 – A 32-year-old woman complained of intermittent right loin pain over the previous 2 years. There were no associated symptoms and no history of trauma. The pain was preceded by certain activities such as sitting, leaning forward, and interestingly she found that using a swing machine was especially likely to produce discomfort. She had been extensively investigated and treated in various specialties with no result. On examination we found that manipulation of the tip of the right 12^th rib exactly and dramatically reproduced her pain. The pain was relieved completely following infiltration of 12^th rib tip with 2 ml of 1% lignocaine. The analgesia persisted for a time consistent with the expected duration of the local anesthetic. Successive intercostal nerve blocks with 5 ml of 0.25% bupivacaine and long-acting steroid methylprednisolone acetate (40 mg) under image intensifier produced complete pain relief. Patient again came with complaints of pain after 2 months of pain-free period. This time her pain was less in intensity. Intercostal nerve block was repeated with 5 ml of 0.25% bupivacaine and methylprednisolone (40 mg). On subsequent visits; she was pain free and was able to be more physically active without inducing pain.

Case 2 – A 40-year-old lady presented with acute right loin pain and a history of intermittent right loin pain for 10 months. The pains were initially sharp but then subsided into a dull ache lasting up to 2 days. The pain radiated to her right groin and subcostal region and was exacerbated by rotation of the trunk. Examination elicited extreme tenderness over the 12^th rib, and manipulation of that rib exactly reproduced her symptoms. A 12^th intercostal nerve block was performed using methylprednisolone (80 mg) in 5 ml of 0.25% bupivacaine. This pain was completely relieved and she did not complain of pain during her subsequent visit.

Case 3 – A 22-year-old female complained of sudden acute pain in left loin whenever she bent forward or attempted to lift anything heavy. She received analgesics, hot pack, and ultrasound treatment. During this period she experienced intermittent period of relief followed by relapses as she tried to increase her activity level. Tenderness over the 12^th rib was elicited during examination and confirmed to be the source of pain under image intensifier. Her pain was completely resolved, following successive 12^th intercostal nerve block with methylprednisolone (80 mg and 40 mg) in 5 ml of 0.25% bupivacaine.

The painful rib syndrome was first described in 1919[2] and officially named in 1922.[3] However, the first series of cases was not reported in the literature until nearly 20 years later. Cases have been reported in children as young as 12 years through individuals in their mid-80s, with the syndrome affecting females slightly more than males.[4,5,6] Bilateral cases have been reported but the condition is almost always unilateral, with pain localized to the tip of the 10^th, 11^th, or 12^th rib, which might be exacerbated by movement.[7]

The syndrome may be the result of trauma but many cases have been reported in which no thoracic or abdominal trauma had occurred. It is thought to arise from irritation of the intercostal nerve by the adjacent hyper-mobile rib cartilage. The anatomy of 12^th intercostal nerve can explain the variability in pain referral. The ventral ramus is larger than that of the other intercostal nerves, and gives a communicating branch to the first lumbar nerve.[8]

The diagnosis can be made simply in a clinical setting by direct examination and manipulation (hooking maneuver) followed with a rib block to see if the pain can be relieved. A majority of the cases may be treated by a frank discussion of the condition with the patient and a warning against those physical activities that tend to create such painful episodes. However, in patients with severe pain and dysfunction, nerve blocks and surgical intervention may be necessary.[6] In all of our patients, pain was completely resolved after intercostal nerve blocks. Local anesthetic and long-acting steroid infiltration to the tip of the affected rib will often produce complete pain relief at least for the duration of the local anesthetic and often long term. The procedure can easily be repeated if required. The immediate pain relief afforded by this procedure is often sufficient to reassure the patient of the “musculo-skeletal” pain diagnosis. In the event of short-term pain relief, more invasive procedure can be considered. These include intercostal nerve block, intercostal nerve cryotherapy, costo-vertebral blocks, percutaneous dorsal root ganglion radiofrequency thermocoagulation performed under image intensifier, and rarely rib excision. [8]

Painful rib syndrome is a fairly common condition and needs to be remembered as a possible cause of visceral and loin pain. Rapid diagnosis and treatment can markedly improve a patient’s quality of life.

Rib Pain | Aurora Health Care 

Feeling pain in your ribs or chest wall can be alarming. You may immediately worry that you’re having a heart attack. Don’t ignore it. Many different conditions, from the very minor to the quite serious – including a heart attack – can cause rib pain. Our experts are here to help quickly pinpoint the cause and provide the best treatment for you.

And if a broken rib is the cause of your pain, you’re in the right place. We specialize in rib fracture stabilization surgery so you can heal faster with less pain and return to your everyday activities more quickly.

What is rib pain? 

In general, rib pain makes it hard for you to take a deep breath, twist your body or put pressure on your chest.

A range of conditions can cause pain, include a pulled muscle, bruised or broken rib, or even acid reflux. Broken ribs are quite common and can take six weeks to six months to heal.

Sometimes though, pain in your rib cage can be a sign of something more serious, such as a heart attack or even cancer.

Because it’s difficult to determine what might be causing your rib pain, get emergency medical help. If you think you’re having a heart attack, call 911 immediately.

Rib pain causes  

Don’t take any chances if you’re experiencing rib or chest pain. Sometimes this pain can be caused by a heart attack. Get emergency care right away; it could save your life.

If a heart condition isn’t the cause of your rib pain, it could be from a:

• Pulled muscle
• Broken or bruised rib
• Internal injury
• Sports injury, accident or fall
• Muscle spasm
• Inflamed cartilage
• Acid reflux, gastroesophageal reflux disease (GERD) or other esophageal conditions
• Anxiety or other conditions
• Cancer

Rib pain diagnosis 

To precisely identify the cause of your rib pain, we’ll ask about your discomfort, listen carefully to your symptoms and give you a thorough physical exam. We may also order radiographic imaging, such as an X-ray or CT scan, to help diagnose the cause.

Find out more about our heart and vascular testing and diagnosis. 

Rib pain treatment 

We’ll develop a treatment plan that works best for you based on your pain level and the underlying injury or condition that’s causing your non-cardiac rib pain.

We may recommend:

• Home care such as rest, cold compresses and anti-inflammatory medication for injuries like a pulled muscle or bruised rib, which often heal on their own with time
• Integrative medicine, such as acupuncture, massage or other holistic treatments
• Pain management of ongoing discomfort for longer-term pain relief that may include steroid injections or counseling
• Physical therapy or rehabilitation, supervised exercise and therapy to help you heal faster and prevent re-injury
• Referral to one of our gastroenterologists, a doctor who specializes in the digestive system, if the underlying cause is linked to your esophagus
• Rib fracture stabilization (rib plating), if you have multiple broken ribs, complicated fractures or an active lifestyle that makes recovery challenging, to help you recover more quickly and less painfully. In this type of thoracic surgery, we connect titanium plates across your broken ribs to stabilize the fractures. 

Chest pain | NHS inform

Chest pain can be caused by anything from muscle pain to a heart attack and should never be ignored.

When to get help for chest pain

You should call 999 for an ambulance immediately if you develop sudden severe chest pain, particularly if:

• the pain feels heavy, pressing or tight
• the pain lasts longer than 15 minutes
• the pain spreads to other parts of your body, such as your arms, back or jaw
• you also have other symptoms, such as breathlessness, nausea, sweating, or coughing up blood
• you are at risk of coronary heart disease – for example, you smoke, are obese, or have high blood pressure, diabetes or high cholesterol

If the discomfort is only minor or has resolved, it may be more appropriate to either:

• speak to your GP
• call the 111 service

Could it be a heart problem?

Chest pain isn’t always caused by a problem with your heart, but it can sometimes be a symptom of:

• angina – where the blood supply to the muscles of the heart is restricted
• a heart attack – where the blood supply to part of the heart is suddenly blocked

Both of these conditions can cause a dull, heavy or tight pain in the chest that can spread to the arms, neck, jaw or back. They can also cause additional symptoms, such as breathlessness and nausea.

The main differences between these conditions is that chest pain caused by angina tends to be triggered by physical activity or emotional stress, and gets better with rest after a few minutes.

If you have previously been diagnosed with angina, the pain may also be relieved by your angina medication.

Symptoms that last more than 15 minutes, occur at rest, and include sweating and vomiting are more likely to be caused by a heart attack.

Dial 999 immediately to request an ambulance if you think you or someone else is having a heart attack, or if you have the symptoms above and haven’t been diagnosed with a heart condition.

If you have an angina attack and you’ve previously been diagnosed with the condition, take the medication prescribed for you. A second dose can be taken after five minutes if the first dose is ineffective.

If there is no improvement five minutes after the second dose, call 999 and ask for an ambulance.

Common causes of chest pain

Most chest pain is not heart-related and isn’t a sign of a life-threatening problem. Some common causes of chest pain are outlined below.

This information should give you an idea of whether these conditions may be causing your chest pain, but you should always seek medical advice to make sure you get a proper diagnosis.

Gastro-oesophageal reflux disease (GORD)

Gastro-oesophageal reflux disease is a common condition where acid from the stomach comes up into the oesophagus (gullet).

Common symptoms of GORD include:

• burning chest pain (heartburn)
• an unpleasant taste in the mouth caused by stomach acid coming back up into your mouth

These symptoms usually occur soon after you’ve eaten and get worse if you bend over or lie down.

GORD can often be treated by making lifestyle changes and, if necessary, using medication. Read more about treating GORD.

Bone or muscle problems

If your chest is painful and tender to touch, it may be caused by a strained muscle in your chest wall.  This can be surprisingly painful, but with rest the pain should ease and the muscle will heal in time.

If you have pain, swelling and tenderness around your ribs, and the pain is made worse by lying down, breathing deeply, coughing or sneezing, you may have a condition called costochondritis.

This is caused by inflammation in the joints between the cartilage that joins the ribs to the breastbone (sternum). The symptoms often improve after a few weeks and may be relieved by painkillers.

Anxiety and panic attacks

Some episodes of chest pain occur as part of an anxiety or panic attack.

In addition to chest pain and overwhelming feelings of anxiety, these attacks can cause symptoms such as heart palpitations, sweating, breathlessness and dizziness.

Most panic attacks last for 5 to 20 minutes. In the long-term, you may benefit from psychological therapy and medication, or both. 

Lung conditions

If you have sharp chest pain that gets worse when you breathe in and out, and is accompanied by other symptoms such as a cough and breathlessness, it may be caused by a condition affecting the lungs or surrounding tissue, such as:

• pneumonia – inflammation of the lungs, usually caused by an infection
• pleurisy – inflammation of the membrane surrounding the lungs, also usually caused by an infection

Mild cases of pneumonia can usually be treated with antibiotics, rest and fluids.  For people with other health conditions, the condition can be severe and they may need to be treated in hospital.

Treatment for pleurisy will depend on the underlying cause. Pleurisy caused by a viral infection will often resolve without needing treatment, whereas pleurisy caused by a bacterial infection will usually need to be treated with antibiotics.

Again, people who are frail or already in poor health may need to be admitted to hospital for treatment.

Other possible causes of chest pain

There are many other potential causes of chest pain, including:

• shingles – a viral infection of a nerve and the area of skin around it, which causes a painful rash that develops into itchy blisters
• mastitis – pain and swelling of the breast, which is usually caused by an infection, most commonly during breastfeeding
• acute cholecystitis – inflammation of the gallbladder, which can cause a sudden sharp pain in the upper right side of your tummy that spreads towards your right shoulder
• stomach ulcers – a break in the lining of the stomach, which can cause a burning or gnawing pain in your tummy
• a pulmonary embolism – a blockage in the blood vessel that carries blood from the heart to the lungs, which can cause sharp, stabbing chest pain that may be worse when you breathe in, as well as breathlessness, a cough and dizziness
• pericarditis – inflammation of the sac surrounding your heart, which can cause a sudden, sharp and stabbing pain in your chest, or more of a dull ache; the pain usually worsens when lying down

Some of these conditions can be very serious. Make sure you seek medical advice so you can be correctly diagnosed and treated.

Causes, Symptoms and Treatment Options

Medically reviewed by Drugs.com. Last updated on May 10, 2021.

What is Biliary Colic?

Biliary colic is a steady or intermittent ache in the upper abdomen, usually under the right side of the rib cage. It happens when something blocks the normal flow of bile from the gallbladder. Bile is a liquid that helps to digest fats. Under normal circumstances, bile is made in the liver and stored in the gallbladder. When you eat a meal, bile passes from the gallbladder through the cystic duct and the common bile duct into the small intestine, where it mixes with partially digested food.

Gallstones are the most common reason for biliary colic. If a gallstone blocks either of these ducts, the normal flow of bile into the intestine is disrupted. The muscle cells in the bile duct contract vigorously to try to move the stone, causing the pain of biliary colic. A stricture of the bile duct or a tumor also can block bile flow and cause biliary colic.

Symptoms

A person with biliary colic usually complains of an ache or a feeling of pressure in the upper abdomen. This pain can be in the center of the upper abdomen just below the breastbone, or in the upper right part of the abdomen near the gallbladder and liver. In some people, the abdominal pain spreads back toward the right shoulder blade. Many people also have nausea and vomiting.

Because symptoms of biliary colic usually are triggered by the digestive system’s demand for bile, they are especially common after fatty meals. The symptoms also can occur when a person who has been fasting suddenly breaks the fast and eats a very large meal.

Diagnosis

After you describe your symptoms, your doctor will perform a physical examination, paying particular attention to the upper right portion of your abdomen (the area of your liver and gallbladder). Ultrasound, the same painless procedure used to produce pictures of babies in the womb, can be used to produce pictures of your abdomen so your doctor can look for gallstones. Blood tests also may be done, especially if you have any fever or if your pain persists.

Expected Duration

Most episodes of biliary colic pass after 1 to 5 hours. After the most intense pain passes, your abdomen may continue to ache mildly for about 24 hours.

Prevention

Because biliary colic is usually related to gallstones, it can be prevented by controlling the risk factors for gallstones. Some of these risk factors, such as heredity, increasing age and pregnancy, are a normal part of life. Others, such as obesity and a high-fat diet, are risk factors you can modify through a healthy lifestyle. Women going through menopause who take estrogen (hormone replacement therapy) are also more likely to develop gallstones and biliary colic.

Treatment

At first, your doctor may prescribe pain medication and encourage you to eat a fat-free diet. If the first episode of biliary colic is particularly severe, or episodes of colic keep retuning, surgery to remove the gallbladder (cholecystectomy) usually is recommended. This procedure can be done through small incisions using an instrument called a laparoscope. The procedure usually requires only a brief stay in the hospital, and some people can leave the hospital the same day they have their operation. It is the most widely used treatment in people troubled by painful gallstones, because it is very effective and safe, with no complications in more than 90 percent of cases.

If surgery cannot be done and symptoms of biliary colic are lasting, medication that dissolves gallstones may be used. However, this medication is expensive and can take months or years to work. Also, only small stones will dissolve. Rarely, medication to dissolve gallstones is combined with a procedure called shock-wave lithotripsy, which uses carefully aimed shock waves to break up gallstones. However, in many people treated with medication or lithotripsy, gallstones tend to form again within a few years.

When To Call a Professional

Call your doctor whenever you have severe abdominal pain, with or without nausea and vomiting. If you have symptoms of biliary colic and you suddenly develop a fever and shaking chills, this may signal a gallbladder infection (cholecystitis), so call your doctor immediately.

Prognosis

As long as you have gallstones that can block your cystic duct or common bile duct, you are at risk for repeated episodes of biliary colic. There is also a 25 percent chance that you will develop acute cholecystitis, or some other complication of gallstones, within 10 to 20 years.

External resources

National Digestive Diseases Information Clearinghouse (NDDIC)

http://digestive.niddk.nih.gov/

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

90,000 Chest pain – causes, symptoms and diagnosis, indications for seeking medical attention

Stock! 20% discount on the initial doctor’s appointment for new patients of the clinic with the promo code “FIRST20”.

Almost everyone perceives chest pain as potential heart problems. However, there can be many reasons for unpleasant sensations. In any case, it is impossible to determine on your own what caused the discomfort. Only a qualified doctor can determine the cause.

An incorrect diagnosis, lack of treatment, uncontrolled attempts to anesthetize the place of discomfort often lead to the development of severe pathologies.

To make sure that pain is not a sign of serious illness or to find a treatment for an identified pathology, it is better to visit a doctor. The causes of painful sensations can be caused by diseases of the heart, lungs, gastrointestinal tract and neurological problems. If you do not know which doctor to make an appointment with in the first place, come to the Kutuzov Medical and Diagnostic Center.We have all the specialists who will help you make an accurate diagnosis. Start by making an appointment with a therapist and follow their directions.

Such different chest pain

Thoracalgia is a term for chest pain (from the words “torax” – chest and “algia” – pain).

It can hurt, both on one side of the chest, and in the middle, in the upper or lower part. The nature of the pain is:

• Sharp and stinging.
• Dumb and aching.
• Stitching.
• Compressive.

Among the main reasons for the appearance of a disturbing symptom in the chest are diseases, trauma and pathology:

• Heart and blood vessels.
• Lungs.
• Musculoskeletal system – muscles, ribs and spine.
• Nervous system
• Gastrointestinal tract.

Let’s dwell on them in more detail.

Heart problems

Pain in the chest in the middle or in its left side is found in various heart diseases:

• Ischemic heart disease, angina pectoris – impaired blood flow in the cardiac arteries. Often, an attack of severe pain lasts up to 15 minutes. It occurs during physical exertion, stress, excitement, and passes after rest.
• Myocardial infarction – cell death and scarring of the heart muscle. It is characterized by severe pain in the chest on the left and in the middle, which does not go away after 15-20 minutes.Additional symptoms include weakness, fear of death.
• Pericarditis or myocarditis is an inflammatory process in the muscle or lining of the heart. They are characterized by sharp or aching pain in the chest when inhaling in the middle of the chest, which intensifies while eating or lying down.
• Mitral valve prolapse – in addition to chest pain, it causes shortness of breath, dizziness, and even fainting.
• Pulmonary hypertension – increased pressure in the pulmonary arteries, an attack similar to a heart attack.

A characteristic feature of heart pain is that it often occurs against the background of emotional or physical stress, accompanied by a feeling of panic, fear of death.

Lung disease

This is a common cause of chest discomfort. The main causes and characteristic symptoms:

• Inflammation or abscess of the lung – the process proceeds with severe pain in the chest (right or both parts of the chest), fever, cough.
• Pleurisy (inflammation of the pleura) – pain appears with a deep breath, usually accompanied by an increase in body temperature, cough.
• Pulmonary embolism with a blood clot – there is a sharp pain in the chest, tachycardia, difficulty breathing.
• Pneumothorax – the accumulation of air in the pleural cavity with damage to the lungs due to injuries to the ribs, spine. There is pain when inhaling, shortness of breath, dry cough, blood pressure may decrease.
• Bronchial asthma – acute spasms pass with pain and wheezing in the chest, wet cough, bouts of shortness of breath

Diseases of the gastrointestinal tract

The main diseases that cause pain in the esophagus, or can spread from the abdomen to the chest area:

• Gastroesophageal reflux disease (GERD) – irritation of the esophageal mucosa due to the reflux of gastric contents.
• Dyskinesia or perforation of the esophagus is an increase in pressure in the esophagus due to slow movement of food or rupture due to trauma.
• Stomach ulcers.

Gastrointestinal diseases are characterized by pain that appears before, after or during meals, they can be accompanied by heartburn and other symptoms.

Injuries and diseases of the musculoskeletal system

Thoracalgia appears due to injuries, diseases of the spine, exacerbated after physical exertion. The main causes and symptoms are:

• Osteochondrosis, hernia and protrusion of intervertebral discs in the thoracic spine, scoliosis – cause chest pain, which increases with movement or prolonged immobility.
• Rib fractures.
• Muscle spasms, sprains, intercostal neuralgias – cause chest pain on the right or left, depending on the place where the pathology arose.
• Tietze’s syndrome or inflammation of the costochondral joints.
• Pain of a neurological nature – from “chills” in the chest to severe pain occur due to mental disorders, with panic attacks.

Pain in the right or left side of the chest may have other causes: neoplasms in the lungs or mammary gland, shingles, and other diseases.

The doctor’s task is to make a diagnosis on time and correctly. This will help: heart examinations, ultrasound, radiography and other diagnostic procedures.

Emergency medical care is needed if:

• Acute chest pain does not go away after 15 minutes and after rest.
• There is dizziness, shortness of breath, increased sweating, palpitations.

In other cases, it is also advisable not to postpone a doctor’s consultation for a long time.Who to turn to – a cardiologist, a neurologist, a gastroenterologist depends on the symptoms. But this is not always possible to determine on your own. In this case, start by consulting a therapist who will help you understand the issue and, if necessary, refer you to a narrow specialist.

In other cases, it is also advisable not to postpone a doctor’s consultation for a long time. Who to turn to – a cardiologist, a neurologist, a gastroenterologist depends on the symptoms. But this is not always possible to determine on your own.In this case, start by consulting a therapist who will help you understand the issue and, if necessary, refer you to a narrow specialist. Be healthy!

Diagnosis of any disease requires modern equipment and vast medical experience. Especially when it comes to chest pain.

Our clinic offers its patients a full range of medical research using high-precision equipment. Our doctors select the most informative and safe diagnostic methods.

Turning to us, you can be sure that the cause of the pain will be established as quickly and accurately as possible. High-tech diagnostic devices allow you to track the work of all organs and systems without causing you unnecessary discomfort.

We value the time of our patients, therefore all consultations and procedures are carried out by appointment. By booking your appointment, you can be sure that the doctor will be waiting for you. Come to the clinic to find out the cause of your pain and discuss treatment options.

The content of this article has been checked and confirmed for compliance with medical standards by a cardiologist of the highest qualification category, a general practitioner
Pilenitsyn Andrey Yurievich.

Prices

90,000 Chest and chest pain

Chest pain is not always accompanied by any serious health problems.The causes of discomfort and pain can be banal overeating, emotional stress, and other relatively harmless transient factors. However, conditions that are much more dangerous to health and even a person’s life can be manifested by the fact that a person has chest pain.

In any case, this is an alarming symptom, to try to ignore which is at least unreasonable. To identify the reason why a patient develops chest pain, it is necessary to contact a therapist who, as part of the initial appointment, will collect an anamnesis of a possible illness, examine the patient and, if necessary, send him to be tested and examined./

Based on their results, it will be possible to judge whether a person will need the help of a narrow-profile specialist – a cardiologist, gastroenterologist or neurologist – or whether an effective treatment can be immediately prescribed that will help to quickly get rid of the symptoms that bother a person.

Why chest hurts: the most common and significant causes

Here are serious and not so serious reasons provoking the appearance of pain in the chest in a patient:

• myocardial infarction in 9 cases out of 10 is accompanied by more or less severe chest pain.She can accompany the patient for a long time, and it is impossible to just take and get rid of her by taking pain relievers or just getting a good night’s sleep. A heart attack is a very serious heart disease and should be kept in mind for those who experience chest pains triggered by stress or physical activity at times. It often happens even in very young women and men;
• a disease such as angina pectoris is a common cause of painful sensations localized in the upper part of the body.Most often, attacks last about a quarter of an hour, and pain is felt throughout this time;
• Often a feeling of chest pain, resembling a burning sensation in nature, develops in patients suffering from heartburn;
• anything that contributes to excessive tone of the chest muscles – namely, some types of physical activity, various injuries, as well as a strong cough – may be accompanied by pain, which increases with gentle but confident pressure on the corresponding part of the body;
• In patients with an overly excitable nervous system, unpleasant symptoms from organs located inside the chest – including the heart muscle – are often accompanied by a reaction of the body to stress.Rapid and chaotic heartbeats, as well as rapid shallow breathing, feeling short of breath and panic, as well as chest pains are the most common of these;
• pathologies of various organs of the gastrointestinal tract – for example, cholecystitis and stomach ulcers – can manifest themselves as pains not only in the corresponding localization of organs, but also in the chest;
• pulmonary artery thrombosis, or its embolism, is manifested primarily by suddenly developing acute pain in the chest, which intensifies at the time of inhalation and exhalation.This is an extremely dangerous acute condition that requires immediate hospitalization.

When is a medical emergency needed to treat chest pain?

Call an ambulance in the following cases:

• Severe chest pain developed after exercise. May be accompanied by the development of unconsciousness in the victim;
• chest pain “radiates” to the patient’s back, neck and lower jaw;
• persistent pain within a quarter of an hour after the patient has taken a comfortable, immobile position;
• discomfort, pain and tightness in the chest accompanied by a rapid heartbeat or arrhythmia, excessive sweating, dizziness, vomiting, or fainting;
• sharp pain accompanied by coughing up blood;

90,021 pain that develops after eating and does not subside until the person takes the antacid medication.

In our private clinic in Ryazan, patients are treated by specialists of the highest qualification category, who will quickly find out what caused the pain and prescribe an effective therapy. Treatment of chest pain in our clinic is the key to returning to an active life and completely getting rid of all the symptoms causing discomfort!

90,000 Which doctor should I contact with chest pain

Moscow therapists – latest reviews

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Show 10 reviews of 12,357 90,000 Chest pain: symptoms and causes of breast pain

May 10, 2018

Breast pain: symptoms and causes of occurrence

Contents

1. What is mastalgia
2. Causes of breast pain
3. Types of pain
4. Make an appointment
5. Chest pain before menstruation
6. Breast pain in nursing mothers
7. Mastalgia with menopause
8. Examination by a mammologist in our center: features

Chest pain: causes and symptoms

Pain in milk glands, according to a study published in 2016 by Turkish mammologists, 70% of women from 20 to 50 years old felt at least once in their life.This symptom in medicine is called mastalgia, and it is based on various reasons. Chest pain does not always indicate a serious illness, and clinical treatment for this condition is necessary in 20% of cases. But mastalgia creates discomfort in everyday life and can still be a symptom of the disease. Therefore, the first step in dealing with it is to understand the reason for its appearance.

Why does the chest hurt when pressed

Pain in the mammary glands can occur for a variety of reasons.Let’s divide them into 3 groups.

1. Hormonal changes

Chest often hurts in the second phase of the menstrual cycle, during pregnancy or menopause. This is normal, because at this time there is a complete hormonal restructuring of the body. You can read in detail about the feelings of a woman in each of these periods below.

2. Diseases of the breast

Aching pain in the mammary gland signals the development of fibrocystic changes.Then it is spilled and cyclical. Intermittent pain sometimes indicates cysts or tumors. In this case, the unpleasant sensations are one-sided, pulling and aching. If the left breast hurts in women, this may be a signal of cardiac pathology.

3. Other causes

Periodically severe pain in the mammary glands occurs due to wearing uncomfortable and tight underwear. The cause may be chest injuries, as a result of which unpleasant sensations appear with pressure and at rest.Don’t forget about infectious and inflammatory diseases.

In any case, a professional examination by a mammologist is mandatory and necessary. Before that, we recommend that you conduct a self-examination at home. The doctor will tell you the rest.

What exactly do you feel

Unpleasant sensations in the mammary gland are different:

• you can feel pain in the right breast or in the left, in two glands at the same time;
• to be localized at one point or spread to the entire area of ​​the mammary gland;
• be harsh and sudden or persistent;
• felt acute and cramped or mild and rare.

Regardless of how the painful sensations manifest themselves, they cannot be ignored. Yes, discomfort often appears on certain days of the menstrual cycle and is not a warning sign. But you cannot define it yourself. Only a doctor can help you find out the reasons for your poor health and get rid of it. Make an appointment with a mammologist by filling out the form below to solve a problematic issue for yourself. You can also ask clarifying questions by calling 044-344-65-32.

Make an appointment at the center

Chest pain before menstruation

The pain, which depends on hormonal changes during the menstrual cycle, is cyclical.The main features of this mastalgia:

• Most often affects both mammary glands after, before or during menstruation.
• Expression is felt in the upper outer chest and sometimes laterally in the armpit.
• The most pronounced becomes 7-10 days before the onset of menstruation.
• Disappears after menstruation.

Medication can help relieve uncomfortable chest pain. But they can only be taken with the permission of a doctor.The fact is that pain in the mammary gland can also indicate diseases of the nervous, endocrine and cardiovascular systems.

Please note that if it is not soon before the start of the menstrual cycle, and pain when pressing, and not only, worries, then the reason may not be hormonal changes.

Mastalgia in lactating women

During pregnancy and lactation, the female body experiences serious hormonal disruptions, the cells of the glandular tissues begin to grow, and the breast increases in volume.Because of this, strong pressure arises on the nerve endings of the organ, which leads to unpleasant sensations and stabbing pain.

The mammary glands can be sore due to the flow of milk. To avoid stagnation, it is necessary to express regularly and correctly. Breastfeeding women need to be constantly examined for halos. If cracks and small wounds have formed on the chest and sore in the nipple area, it may be purulent mastitis. See your doctor to see if an infection develops in the organ.

Pain in the mammary glands with menopause

If you have not had a period for 12 months, it means that the postmenopausal period has come.Mastalgia in this case is non-cyclical, it can be short-term or intermittent, pulling and sharp, accompanied by an increase in body temperature and general malaise.

If after the onset of menopause you have a tingling sensation in the mammary gland or you feel discomfort, this indicates a problem. Regardless of the type of pain, immediately seek the advice of a specialist.

Diagnosis of mastalgia at the Specialized Breast Center

As we mentioned above, chest pains can occur during a period of hormonal surge in the body or indicate serious illnesses.Every woman who feels chest discomfort needs a doctor’s consultation. He will either tell you how to reduce recurrent pain, or diagnose the disease and prescribe an effective treatment.

To determine the causes of mastalgia in women, palpation, ultrasound, mammography and other diagnostic procedures are performed. You can also be examined by a gynecologist or endocrinologist.

Our center is the only one in Ukraine, whose doctors specialize in breast diseases. Practitioners with over 10 years of experience will conduct a full examination, identify the cause of breast pain and answer all your questions.To sign up, call 044-344-65-38 or fill out the form above.

Can the heart hurt? | Health Blog “Ramsey Diagnostics”

Headache or heaviness in the back rarely frightens patients. And chest discomfort usually triggers panic, and for good reason. Few can quickly distinguish between the symptoms of angina pectoris and neuralgia and correctly assess the risks. Can a heart ache in a young and healthy person? Maybe your heart is okay, and the pain causes pinched nerves or an attack of gastritis? There can be many reasons, and they, for our good luck, have different symptoms.

Probable causes of pain

There are many diseases that can cause painful sensations in the chest. A small part belongs to the heart, and it consists almost entirely of acute conditions:

• vascular pathologies: heart attack, angina pectoris, aortic dissection;
• inflammatory processes: myocarditis, pericarditis, endocarditis;
• congenital pathologies: valve prolapse, heart disease, cardiomyopathy, arrhythmias.

Pain from almost all organs of the abdominal cavity, spine, ribs, and lungs can spread to the upper part of the chest.Even stretched chest muscles can cause heaviness and pain that can easily be mistaken for heart problems. Discomfort in the chest can result from:

• pathologies of the spine and musculoskeletal system: osteochondrosis, scoliosis, neuralgia;
• lung diseases: pleurisy, pneumonia, abscess;
• diseases of the gastrointestinal tract: stomach ulcer, hernia of the esophagus, acute pancreatitis, gallbladder dyskinesia;
• psychological problems: heart neurosis, stress.

Can the heart hurt like the stomach and spine? Symptom Differences

Symptoms in diseases are similar: pulling pain, tingling, acute attacks. The pain can radiate to the shoulder, arm, back and lower abdomen. Heart problems should be suspected if the following occurs:

• feeling of heaviness and squeezing;
• burning in the region of the heart;
• manifestation of attacks and gradual worsening of symptoms;
• A sharp change in pressure or pulse in either direction (the main symptom of heart disease).

If we talk about diseases of internal organs, then the pressure and heart rate will not change with them. Only with perforation of the stomach ulcer will the pressure drop sharply due to internal bleeding. Usually, chest pain is caused by much less dangerous conditions. They can be distinguished by the following sensations:

• tingling,
• shooting,
• pain manifests itself with sudden movements or coughing,
• painful sensations do not subside and are constantly present.

Doctors advise taking nitroglycerin for any suspicion of heart pain. If he did not help, then this is either organ diseases or an acute heart attack, which can be distinguished from neuralgia and pneumonia by the intensity of the symptoms.

Possible heart disease

With chest pain, the very first thing that comes to mind is heart attack – necrosis of the heart muscle. This is a dangerous condition that requires immediate medical attention. Otherwise, it can even lead to death.The main symptoms are:

• chest pain radiating to the left arm, jaw, back and right side;
• weakness, feeling of panic fear;
• nausea, pallor, abdominal pain;
• in the case of an extensive area of ​​necrosis – loss of consciousness, blue color of the lips and nails, impaired breathing.

Ischemic disease , or angina pectoris – partial or complete blockage of the coronary arteries. It often develops against the background of high blood pressure, a sedentary lifestyle, and excess weight.In addition to pain, shortness of breath and weakness, the patient feels heaviness, as if a load was placed on the chest.

Aortic rupture causes such an acute attack of pain that the person faints. Massive internal bleeding begins, and urgent medical attention is required to save life.

Pericarditis , endocarditis , myocarditis – inflammation of different parts of the heart: the shell, valves and the muscle itself. They are caused by infectious diseases such as tuberculosis, syphilis, or fungal infections.Symptoms are similar to angina pectoris – pain, heaviness in the chest, shortness of breath. The patient is more comfortable in a semi-sitting position, his temperature rises and noticeable edema appears.

Arrhythmia rarely brings significant discomfort. With her, pain is felt only in the heart, without leaving it. It is often so weak that you may not even be aware of its presence until you have had a planned EKG.

How to recognize non-heart diseases?

They can be divided into three main groups: diseases of the musculoskeletal or nervous system and the gastrointestinal tract.

• among pathologies of the musculoskeletal system can cause chest pain osteochondrosis, hernia, tendonitis, arthritis. In the first case, the pain is caused by pinching of the nerve endings by the curved spine. The sensations will be unpleasant, but weak. They may be accompanied by tingling and numbness in one or both arms, shoulders, and chest. Hernias in the later stages cause severe pain that subsides if the patient assumes a comfortable, relaxed position. Despite the reflection of pain in the chest and abdomen, the focus is felt in the region of the spine.Joint diseases are easily distinguished by reduced mobility.
• Chronic diseases of the gastrointestinal tract (for example, an attack of gastritis) cause mild aching pain. Acute conditions – stomach ulcer, pancreatitis, blockage of the bile ducts – cause unbearable pain localized in the middle or side of the abdominal cavity, but which is reflected in the heart, back and even shoulders. With problems with the gastrointestinal tract, the patient feels nausea, weakness, sweating. For any acute pain in the abdominal cavity, you should immediately call an ambulance!
• Diseases of the nervous system are not only neuralgia with acute pain with sudden movements, but also a neurosis of the heart.Neuralgia is easy to distinguish by its point localization. With stress, fatigue and lack of sleep, the pain is weak, aching and constant, intensifying after nervous tension.

Unpleasant sensations can cause respiratory diseases. However, they can be easily distinguished by coughing, fever and noises in the bronchi.

Diagnosis of possible diseases

In an acute condition, you need to go to an ambulance – due to necrosis of the heart tissue or internal bleeding, the count goes for minutes.But you should start examining the body even with mild chest pain – if you detect the disease in time, you can prevent it from developing into a severe form.

For the diagnosis of the heart, the following are usually used:

• ECG – the simplest and most well-known examination,
• Coronary angiography of the heart – the study of the state of the arteries and heart valves,
• Ultrasound of the heart – according to its results, the state of the entire heart muscle and its individual structures can be seen.

If heart disease has been excluded by symptoms or tests, other tests may help:

• Fluorography or CT of the chest to assess the state of the respiratory system,
• CT of the chest for a detailed examination of the spine,
• MRI of the thoracic spine will allow you to examine the bone and nerve structures in more detail,
• Ultrasound of the abdominal organs – pathologies will be visible on it gallbladder and pancreas,
• Gastroscopy to examine the walls of the esophagus and stomach.

Do not delay research for chest pain, as you can miss the treatment period. If you try to diagnose yourself, you can make a mistake and aggravate the problem. Only a specialist will be able to direct you to the necessary examinations, draw the correct conclusions from the examination and be able to suggest treatment. And do not forget that for any attacks of severe chest pain, you should go to an ambulance – you can underestimate the symptoms and miss a serious pathology.

90,000 Where is the cunning intercostal neuralgia hiding / Health / Nezavisimaya gazeta

In medical practice, there are often cases when a true ailment is disguised as other diseases

Often a spasm becomes a harbinger of an ailment.Photo Depositphotos / PhotoXPress.ru

The term “neuralgia” translated from Greek means intense pain that spreads along the trunk of the nerve or its branches. Let’s say a person thinks that he is worried about pain in the heart, and as a result of the examination it turns out that he has intercostal neuralgia. In this case, it is caused by irritation or compression of the nerves located between the ribs.

The cause of intercostal neuralgia can also be trauma in the chest and back, sudden physical exertion, prolonged stay in an uncomfortable position or in a draft.The provoking factors include hypothermia, stress, metabolic disorders, deficiency of B vitamins, colds and flu. In all these cases, a focus of inflammation is created in the chest.

The main symptom of the disease is pain. But often a harbinger of an ailment is a spasm in the chest area, to which many people do not attach serious importance. And the pain – burning or aching – comes later. It spreads along the intercostal spaces and can be paroxysmal or constant.An important diagnostic feature is its spasmodic nature. In addition, it can be targeted, for example, it makes itself felt in the region of the heart, under the scapula or in the lower back. Of the accompanying symptoms, tension and twitching of the back muscles, numbness along the intercostal nerves, redness or, conversely, pallor of the skin, should be noted.

Intercostal neuralgia is also called a “cunning” disease. The fact is that, depending on the location of the pain, it can, for example, mimic lung disease, shingles, or even renal colic.But it is especially often confused with angina pectoris, a form of coronary heart disease. What is important to know in this regard?

With neuralgia, chest pain often does not let go of a person, day or night. It is localized to the right or left between the ribs, has a punctate or small-area manifestation (a person can indicate with his finger where it hurts), intensifies when probing the intercostal spaces, changing body position, walking, breathing deeply or exhaling, coughing, sneezing.

Another thing is an attack of angina pectoris, which is often caused by physical exertion, lasts about 10-15 minutes and disappears after taking the medication prescribed by the doctor.Heart pain, as a rule, is localized in the center of the sternum, sometimes radiates to the left hand, but unlike neuralgic pain it does not have a point character. For example, if you ask a person where his pain is, he will point to the entire chest area. In addition, pain in angina pectoris does not change with deep inhalation and exhalation, does not depend on changes in body position or movement.

To what has been said, we add that only a doctor can recognize this or that ailment, who should be consulted in any case.

Diagnosis of intercostal neuralgia includes a blood test, ECG, X-ray, and, if necessary, computed tomography. Based on the results of these studies, the doctor will make an accurate diagnosis and prescribe the appropriate treatment. As a rule, it is complex and is aimed primarily at the treatment of the underlying disease, for example, osteochondrosis or herniated disc.

If the cause of intercostal neuralgia is a cold or shingles, these diseases are treated.As for the regimen that the patient must observe, in the acute period of intercostal neuralgia, he is recommended to bed rest for 1-3 days. It is advisable to lie on a firm and level surface, for which you can put a wooden shield under the mattress.

Drug therapy includes, in particular, pain relievers and anti-inflammatory drugs, which are prescribed by a doctor. The use of dry heat gives a good effect. For this purpose, you can bandage the chest with a woolen scarf.The complex of treatment methods also includes massage, manual and acupuncture, various physiotherapy procedures.

The recommendations of traditional medicine are also used, for example, indoor geranium, which relieves pain well. To do this, a leaf of this plant must be rubbed into a sore spot, and then tied with a woolen scarf on top. Rubbing fresh horseradish juice or black radish into the skin along the inflamed nerve roots also helps to reduce pain.

Prevention of intercostal neuralgia – physical exercises that develop muscles and strengthen the spine, as well as swimming.Hypothermia, prolonged stay in an uncomfortable position, excessive physical exertion, especially for the elderly, should be avoided. And, of course, eat rationally, not forgetting to include foods rich in B vitamins in the diet.

90,000 Armpit pain (armpit pain)

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Armpit pain (pain in the armpit) is a subjective symptom of various diseases, in which one of the signs is the appearance of pain in the armpit. The axillary region is an anatomical area that is located between the lower edge of the pectoralis major muscle, the lower edge of the vastus dorsi and the major round muscle, as well as between the line drawn between the indicated muscles at the point of their departure from the chest and the line that connects the indicated muscles on the medial surface shoulder.The surface of the armpit is covered with skin and subcutaneous fat. A characteristic feature of this zone is the presence of a large number of sweat glands. In addition, there are superficial and deep lymph nodes in the armpit.

What is he talking about?

Pain in the armpit is a symptom of various diseases, and of different body systems. It is:

1. Pain resulting from trauma to the chest and axillary region.
2. Pain arising from diseases of the mammary glands.
3. Pain associated with the pathology of the lymph nodes and blood vessels.
4. Pain caused by inflammatory processes in the sweat and sebaceous glands (hydradenitis, suppurative atheroma, etc.).
5. Pain that may be associated with infectious and inflammatory processes of the skin (streptoderma, staphyloderma).
6. Pain caused by pathology of the nervous system, as well as the human cardiovascular system.

In addition, it is possible that armpit pain may be caused by allergic skin reactions, as well as be associated with previous surgical interventions on the mammary glands.

Pain in the armpit can be acute and chronic, unilateral and bilateral. The nature of the pain can also be different. Armpit pain can be cyclic and acyclic. Cyclic armpit pain in women indicates here or another pathology on the part of the mammary glands. In this case, very often pain in the armpit is combined with pain in the mammary glands themselves. Along with the pain syndrome, other signs are determined that indicate pathology on the part of the mammary glands: the presence of seals in the chest, nodes in the mammary gland, discharge from the nipples, as well as diffuse changes and changes in the skin.

At the same time, armpit pain may be the only symptom, especially in cases of neoplastic process in the mammary glands. The mechanism of such pain is associated with damage to the lymph nodes.

Differential diagnosis

In cases of armpit pain in women, it is required to carry out differential diagnostics in order to exclude other pathology that is not associated with diseases of the mammary glands. In most cases, this can be done already during a face-to-face examination.Diagnostics of subcutaneous neoplasms, pustular skin diseases, allergic processes does not cause difficulties. The presence of cicatricial deformities of nearby departments and a history of surgical interventions rather indicate that the cause of pain is the intersection of the neurovascular pathways during previous operations. In these situations, skin numbness is often observed, as well as its increased sensitivity.

Difficulties can be caused in cases of diseases of the heart and blood vessels.In this situation, the methods of instrumental diagnostics come to the rescue: ECG, ultrasound of the heart, ultrasound of the mammary glands, X-ray research methods.

In the event of pain in the armpit in women and in the absence of external changes in the skin, as well as normal indicators in the work of the heart, it is recommended to begin the examination with a visit to the mammologist, who will determine the plan for further study of the cause of the pain.

• Oncomammology

• Mastopathy

• Cystic pathology

• Seals, units

• Pain

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